{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:34:48Z","timestamp":1787830488107,"version":"build-2784847793"},"reference-count":13,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23AR0614415"],"award-info":[{"award-number":["K23AR0614415"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2021,10,29]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Epidemiological studies have shown that discoid lupus erythematosus (DLE) has a higher incidence and prevalence in racial\/ethnic minority groups, particularly Black individuals. The objective of this retrospective cohort study was to identify the differences in DLE lesion distribution and characteristics in Black individuals compared with non-Black individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>183 patients with DLE (112 Black patients and 71 non-Black patients) with a reported race\/ethnicity and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) scores were included in this retrospective cohort study. Univariate analysis was performed to determine significant differences in demographic data, clinical characteristics, DLE lesion distribution and DLE lesion characteristics in Black and non-Black patients with DLE. Multivariable logistic regression was preformed to determine significant predictors of DLE lesion location and characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Black patients with DLE had worse baseline CLASI damage scores compared with non-Black patients with DLE (median (IQR): 10.0 (6.0\u201314.5) vs 6.0 (3.0\u201310.0), p&lt;0.001) and had 48.9 greater odds of dyspigmentation in any anatomical location (p&lt;0.001). Black patients had 2.54 greater odds of having scalp involvement (p=0.015) and 1.97 greater odds of having ear involvement (p=0.032) compared with non-Black patients. Black patients also had greater odds of scalp dyspigmentation (OR=5.85, p&lt;0.001), ear dyspigmentation (OR=2.89, p=0.001) and scarring alopecia (OR=3.00, p=0.001) compared with non-Black patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Signs of disease damage, particularly ear dyspigmentation, scalp dyspigmentation and scarring alopecia, can more frequently affect Black patients with DLE. Recognising differences in clinical presentation of DLE among Black patients can assist future efforts with understanding biological, cultural, psychosocial and systemic factors that influence DLE presentation and outcomes in Black patients and may guide clinicians when counselling Black patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2021-000514","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T11:24:30Z","timestamp":1638357870000},"page":"e000514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Discoid lupus erythematosus skin lesion distribution and characteristics in Black patients: a retrospective cohort study"],"prefix":"10.1136","volume":"8","author":[{"given":"Adrienne K","family":"Joseph","sequence":"first","affiliation":[{"name":"Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Windsor","sequence":"additional","affiliation":[{"name":"Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda S","family":"Hynan","sequence":"additional","affiliation":[{"name":"Population and Data Sciences, Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-7658","authenticated-orcid":false,"given":"Benjamin F","family":"Chong","sequence":"additional","affiliation":[{"name":"Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"key":"2025091515223539000_8.1.e000514.1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.12788\/cutis.0038","article-title":"Psoriasis in patients of color: differences in morphology, clinical presentation, and treatment","volume":"106","author":"Nicholas","year":"2020","journal-title":"Cutis"},{"key":"2025091515223539000_8.1.e000514.2","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1001\/jamadermatol.2019.2063","article-title":"Assessment of black patients' perception of their dermatology care","volume":"155","author":"Gorbatenko-Roth","year":"2019","journal-title":"JAMA Dermatol"},{"key":"2025091515223539000_8.1.e000514.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.0022-202X.2005.23889.x"},{"key":"2025091515223539000_8.1.e000514.4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2165\/11536930-000000000-00000","article-title":"Postinflammatory hyperpigmentation: etiologic and therapeutic considerations","volume":"12","author":"Callender","year":"2011","journal-title":"Am J Clin Dermatol"},{"key":"2025091515223539000_8.1.e000514.5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/bjd.12653","article-title":"The impact of skin damage due to cutaneous lupus on quality of life","volume":"170","author":"Verma","year":"2014","journal-title":"Br J Dermatol"},{"key":"2025091515223539000_8.1.e000514.6","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2018-000291"},{"key":"2025091515223539000_8.1.e000514.7","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.jaad.2016.02.1162","article-title":"All hairstyles are not created equal: what the dermatologist needs to know about black hairstyling practices and the risk of traction alopecia (TA)","volume":"75","author":"Haskin","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"2025091515223539000_8.1.e000514.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816614"},{"key":"2025091515223539000_8.1.e000514.9","unstructured":"BS L , Maibach HI . Ethnic skin and hair and other cultural considerations. Springer International Publishing, 2021."},{"key":"2025091515223539000_8.1.e000514.10","first-page":"26","article-title":"African American women, hair care, and health barriers","volume":"7","author":"Gathers","year":"2014","journal-title":"J Clin Aesthet Dermatol"},{"key":"2025091515223539000_8.1.e000514.11","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1001\/jamadermatol.2021.0338","article-title":"An approach to examining tightly coiled hair among patients with hair loss in Race-Discordant patient-physician interactions","volume":"157","author":"Grayson","year":"2021","journal-title":"JAMA Dermatol"},{"key":"2025091515223539000_8.1.e000514.12","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1002\/acr.23578","article-title":"Racial disparities in the incidence of primary chronic cutaneous lupus erythematosus in the southeastern us: the Georgia lupus registry","volume":"71","author":"Drenkard","year":"2019","journal-title":"Arthritis Care Res"},{"key":"2025091515223539000_8.1.e000514.13","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2019-000344"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2021-000514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T22:22:46Z","timestamp":1757974966000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2021-000514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12,1]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/lupus-2021-000514"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2021-000514","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}